• Considerate, respectful, and safe care that is free from abuse or harassment.
• A discussion of your illness, what we can do about it, and the likely outcome of care. 
• Know the names and roles of the people caring for you here. 
• Respectful and effective pain management. 
• Receive as much information to consent to or refuse a course of treatment or invasive procedure, and to actively participate in decisions regarding your medical care. 
• Involve your healthcare proxy or significant others in the decision-making process for medical decisions. 
• Reasonable continuity of care and to know in advance the time and location of an appointment as well as the doctor you are seeing.
• Full consideration of personal privacy and confidentiality of your medical information. Your written permission will be obtained prior to releasing any medical information. When we do release your information to others, we ask them to keep it confidential.
• Review your medical record and ask questions, unless restricted by law.
• Know of any relationships with other parties that may influence your care.
• Know about rules that affect your care and about charges and payment methods. You have a right to receive and examine an explanation of your bill, regardless of the source of payment.
• Receive assistance with the transfer of care from one doctor to another doctor within our practice or to an external doctor not in our practice.
• You have a right to develop a living will or healthcare power of attorney although, since the procedures that we do are not high risk, we will do all that is necessary to stabilize you including CPR if an emergency occurs. EMS will be called and you will be transferred to the hospital.
• Voice your concerns, complaints, or problems with the care you received by contacting our administrator at 434 791 1152. If we are unable to satisfactorily address your complaint, you may contact the State Medical Board by phone at 1-800-533-1560, or by mail at Virginia Department of Health Professions, Enforcement Division, Perimeter Center, 9960 Mayland Drive, Suite 300 Henrico, VA 23233-1463 or Online at https://www.dhp.virginia.gov/Complaints
  

• Provide accurate and complete information concerning your symptoms, past history, current health status, and medications including over-the-counter products and dietary supplements. 
• Make known whether you clearly comprehend your medical care and what is expected of you in the plan of care.
• Participate in the development of the treatment plan and follow the care instructions given to you.
• Follow the treatment plan and care instructions given to you.
• Keep appointments and notify us if you are unable to do so.
• Accept responsibility for your actions if you refuse planned treatment or do not follow your doctor’s orders.
• Accept financial responsibility for care received and pay promptly.
• Follow facility policies and procedures.
• Inform my doctor about any living will, medical healthcare power of attorney, or other directive that may affect my medical care.
• Be respectful of all healthcare providers and staff as well as other patients.
• Inform the staff of any discomfort or pain and patient safety issues.
• Share your values, beliefs, and traditions to help the staff provide appropriate care. Patient Rights – You have a right to: Patient Responsibilities - You agree to: Policies and Procedures, 11/2023
• Provide a responsible adult to transport you home and remain with you if you receive sedation medications.
• Provide any Advance Directive information.

All issues, concerns, or complaints can be reported by contacting our Office Manager or Nurse Manager. If we are unable to address your concerns, you may contact the following for assistance.

Medicare Ombudsman: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048 or use this website:

www.cms.gov/center/special-topic/ombudsman/medicare-beneficiary-ombudsman-home

VA Office of Aging Services 800-552-3402

US DHHS Administration on Aging for community-based resources

https://acl.gov/programs

Advance Directives – Living Will or Health Care Power of Attorney Resources

For applicable state laws and sample forms for creating a living will or healthcare power of attorney, you may contact one of the following.

1. Caring Information Organization at 1-800-658-8898 for English or 1-877-658-8896 for other languages or www.caringinfo.org

2. E-mail: Aginginfo@dars.virginia.gov, Toll-Free: 1-800-552-3402 (Nationwide)

Richmond/Henrico local: (804) 662-9333, https://www.vda.virginia.gov/

3. Palliative care, VA dept. Of Health www.vdh.virginia.gov › palliative-care

4. Virginia Advance Directives

http://www.virginiaadvancedirectives.org › forms-1

Advance Directive Policy:

Please be aware that the procedures that we do in this facility are not high-risk and that in an emergency, we will do all that is necessary to stabilize you including CPR.

If you present to this center for a procedure with a living will or valid Do Not Resuscitate Order (DNR) or Out of Facility form and you have an emergency, we will do all that we can to stabilize your medical condition and start resuscitation. We will call 911 to transport you to the hospital. EMS will be informed of the Do Not Resuscitate Order or living will upon arrival.